Organization
ADAMS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMMY A ELMOSA (OWNER)
(708) 952-0000
Entity
Organization
Contact information
Practice address
5600 W 87TH ST, BURBANK, IL 60459-2902
(708) 952-0000
(708) 952-0001
Mailing address
5600 W 87TH ST, BURBANK, IL 60459-2902
(708) 952-0000
(708) 952-0001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025131
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004717
—
IL
Enumeration date
04/14/2011
Last updated
04/14/2011
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